Statins in neurological disorders: mechanisms and therapeutic value

Statins are well-tolerated, mainstay drugs in cardiovascular risk management. In addition to their cholesterol-lowering properties, statins also have anti-inflammatory, vasculoprotective, and antioxidant effects. They have also been associated in some epidemiologic studies with reduced risk of Alzheimer's disease (AD), and a link between cholesterol and late-onset AD has been documented. Experimental studies in cell culture systems and animal models show that statins have neuroprotective effects that may ameliorate the damage inflicted by stroke and AD. Human studies have garnered compelling evidence that treatment with statins reduces ischemic stroke incidence independent of their lipid-lowering effects. There is also the possibility that statins and extremely low cholesterol levels may increase the risk of intracranial hemorrhage. In this review, we discuss the potential reasons for the effect of statins on stroke and AD, and the multiple mechanisms of action of this class of lipid-lowering drugs.